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With over 35 years of experience working with individuals to help them get the most out of their Social Security benefits, and a former Social Security Administrator himself, Jim Blair has developed this great Social Security Retirement Guide. Numerous companies have put their trust in Jim Blair as a consultant and seen positive results, and now these results are available to you as an individual with this guide. The Social Security Administration as an organization is notoriously unhelpful to claimants, because the huge number of claimants it faces everyday means they don't have time to go into as much detail with each individual claim as you need. With the Social Security Retirement Guide, you will be able to make a clear, informed decision about this important process, as otherwise you could miss out on hundreds of dollars a month. Your purchase entitles you to two free bonus ebooks: The Newbie Guide to Frugal Living and the Ultimate Baby Boomer's Guide. Both of these books give you valuable advice to make your money go even further, so that you can spend your autumn years free from worrying about how you will be able to afford the things that you deserve.

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Public Pension Programs

Almost all industrialized countries have established public pension programs that collect taxes from the current working population, often levied as a payroll tax, to provide benefits to the current retired population. An example of this approach is the Social Security program in the United States. This type of pension system is referred to as an unfunded pay-as-you-go (PAYG) pension, reflecting the fact that the contributions of current workers are not being invested in assets to be used to finance their own retirement. Rather, the current generation of workers is supporting current retirees, and the current generation will be dependent on contributions of future generations to support them in their old age. As currently designed, PAYG public pension programs in Europe, North America, and Japan will need to be altered significantly in order to achieve fiscal sustainability in coming decades (Disney 2000 World Bank 1994). An important reason why projections show that PAYG public...

Benefits to elderly people

The positive effects that pets have on human health can be applied to all age groups but perhaps the greatest benefit that companion animals bring to the elderly is their ability to help them cope with loss. Loss refers not only to the death of close relatives or friends but also to the loss of a job following retirement and the loss of children once they have left home. The bereavement of a spouse can include the loss of a confidante and possible social isolation, thus compounding the effect of prolonged stress. Investigations into the effects of bereavement on the elderly have shown that pet owners suffered significantly less depression than those without pets (Hart 1995). Job loss and the lack of having someone to nurture are factors known to cause low self-esteem and pets can play a vital role in fulfilling the need to nurture and giving reassurance of self-worth (Enders-Slegers 2000).

Four Developmental Subphases in the Mature

Secondly, liberation phase, roughly covering the time between the late fifties to early seventies, people have a sense of if not now, when , and coupled with partial or full retirement this gives the feeling of greater personal freedom to act according to one's own needs. Referring to empirical studies, Cohen claimed that this phase includes a significant shift in personal identity and furthermore that the brain in this age period has the richest number and density of dendrites in the

Family Responsibilities

In 1877, the same year Cassatt joined the Impressionists, her mother, father, and sister Lydia came to live with her in Paris. Her father who had gone back to work after his earlier initial retirement now retired again and he, along with her mother and older sister Lydia were moving to France as their permanent home. Fully accepting the responsibilities for her family, Cassatt gave up her previous apartment-with-studio in the artist's quarter and found a larger apartment on the Rue Beaujon in an elegant neighborhood near the Champs-Elysees that could accommodate the entire family. She also rented a studio for painting in her former neighborhood.

Un nouveau debut A New Beginning

When Paul - husband, friend, and artist - passed away in 1994, Julia continued to write and work on television programming for two years. She had been inducted into the Culinary Institute of America's Hall of Fame in 1993, which elevated her to a new level as the first female inductee. She was awarded France's highest honor, the Legion d'Honneur, in 2000. In 2001 she moved to a retirement community in Montecito, California and donated her house and office to Smith College. Her kitchen, however, including utensils and a collection of 800 knives, was generously donated to the Smithsonian National Museum of American History in Washington, DC. She donated her cookbook collection to the Shlesinger Library at Harvard University. Her legendary pots and pans were brought to Washington, DC from COPIA - reunited and appreciated by a new generation of fans and followers.

Future Research Directions

First, there is an opportunity to expand multidisciplinary work that examines connections across domains. Currently there is a tendency for demographers to focus on population projections, sociologists to focus on family and kin ties, economists to focus on pension and work issues, and epidemiologists to focus on health and disability issues. But each of these domains is linked to the others, and none can adequately be understood in isolation from the others. By working together on research design, investigators from these various disciplines can develop measures and coordinate data collection so that linkages across domains can be studied. One goal would be that policy recommendations could reflect a more complete understanding of population aging that comes from recognizing that the experience of aging is multifaceted.

Methods And Measures

Participation and mortality rates persist indefinitely. These measures are useful for predicting future labor supply and for making decisions concerning, for example, the investment of pension funds. Where labor force participation rates are changing rapidly, or whenever workers experience many exits and reentries into the labor force, these tables will be inaccurate. Recent developments have focused on successfully smoothing the transition probabilities to improve the tables (Land, Guralnik, and Blazer 1994). One criticism of this measurement technique is that the line between the not in the labor force adults and the unemployed is blurry. Gonul (1992) finds that these two states are distinct for young women but not for young men. Kreider (1999) finds that nonworkers in the Health and Retirement Survey overreport work limitations, suggesting that these people may have exaggerated their health conditions to justify their nonparticipation in the labor force. Retirement or disability...

Research Directions

Age Structure and Retirement In the advanced industrial societies, labor force participation rates have typically declined with advancing age. In many countries, there is a customary or even legally enforced retirement age. Programs such as Social Security must carefully model the number of retired dependents who will be eligible for transfer payments. Declining mortality rates have lengthened the number of years that elders will spend out of the labor force (Gendell 2002). In addition, declining fertility rates throughout the industrialized world have made it difficult to replace older workers with younger native-born workers. Thus, the rates of retirement are closely tied to issues of state spending and immigration policy (Coleman 1992). In developing countries, older workers often continue to work almost until the time of death. In advanced industrial countries, the pattern is different (Clark, Ramsbey, and Adler 1999). American labor force participation rates at older ages dropped...

Pleasant Summer

Joan and Bob were particularly happy that month. They had finally decided to build a house near the summer village that we enjoy so much. With difficulty, they had found the right piece of land construction was progressing so well that they thought they would be able to be in the new house before the following summer. The house would be comfortable, possibly for retirement. Joan could see that possibility on the not-too-distant horizon. Jeff had joined the company. In time, he might learn the business well enough to take it over. Ellen had just gotten married and was living near the village with her husband.

Demographic Research On The Level Of Inequality

One of the fundamental indicators of inequality in a population is its level of poverty, which is typically measured as the proportion of households whose income falls below some specified poverty threshold (i.e., the poverty rate).30 Because poverty thresholds vary by household size (and, to a lesser extent, composition), Bumpass and Sweet (1981) note that processes of family formation and change can have direct effects on the incidence of poverty. These demographic factors may also have indirect effects via consequent reductions in labor supply or earnings capacities. Households may thus leave or enter poverty as the result of such demographic changes as marital dissolution, aging, retirement, death, childbirth, remarriage, the departure of children from the household, and the formation of new households.

Description Of Social Patterns And Trends

There is a great social and economic demand for objective information about population characteristics and trends. This need arises, in part, from popular curiosity of people wanting to know if others are like them and share common experiences. Businesses want to know about potential markets for goods and services and whether demand is likely to grow or shrink (see chapter 25, Small Area and Business Demography, in this Handbook). Public authorities also seek information about current and future population size and composition to be able to plan where to locate schools and roads and how much revenue will be needed to provide for future pensions and health care needs. Although these data needs'' are sometimes met by generalizing from one's own (and acquaintances') experiences, it is widely recognized that broader and more representative data provide a more accurate portrait. Demographers, by virtue of their expertise in analyzing and interpreting census data and their scientific...

Second World War and the Navy

The end of the war did not mark the end of Hopper's navy career, however. She remained in the naval reserve, and, as a reserve officer, rose to the rank of commander by 1966. In 1966, however, the navy decided yet again that she was too old to serve. As she told the story to Billings (p. 87), she received a letter from the Chief of Naval Personnel informing her that she had been on reserve duty for twenty-three years, which was more than twenty. 'I knew that,' Grace said. Another paragraph stated she was sixty years old. 'I knew that too,' she said. Against her own inclination, then, she submitted the requested application for retirement. again requested to retire because of her age, this time for the last time. At her retirement, she held the rank of rear admiral she was not only the oldest serving officer but also the only former WAVE on active duty. Hopper returned to the private sector on her retirement from the navy. The value that she herself placed on her navy service is...

Hopper in the Private Sector

When Hopper was discharged from the navy at the close of the Second World War, she remained at Harvard so that she could continue working with computers. Over the next few years, she, along with the other members of the team, worked on the Mack 2 and the Mack 3, the successors of the gadget she had found so appealing in 1944. Because remaining at Harvard was not a viable option for the long term, though, Hopper moved into the private sector, going to work for the Eckert-Mauchly Computer Corporation she remained with this company, through mergers and takeovers and the accompanying name changes, until her 1971 retirement from what had become the Sperry Corporation. By 1971, of course, she had for several years been back on active duty as a naval officer.

Suggested Readings

Finally, as psychiatrists have gained expertise in working more closely with police, there has been a parallel growth in understanding aspects of psychiatric disability specifically related to law enforcement officials. Police departments often seek evaluations of officer fitness for duty. Officers may apply also for disability through private insurance or through state pension funds. Unique job stress, exposure to violence and death, and substance abuse are just some of the factors that play into the potential for psychological sequelae affecting occupational functioning. These types of work-related assessments present distinct challenges to psychiatrists. Given the tight social network among officers, peer relations are important to consider in police fitness for duty assessments. Suicide risk is also important to weigh, given that this group has easy access to firearms. Psychiatrists conducting independent medical examinations of officer fitness for duty or disability must...

Lifetime Productivity

Between the age of 60 and 65 he produced, or closely supervised, 33 papers, compared to 30 during the 5-year period in which he produced the citric acid cycle. After his official retirement, he produced at an even higher rate 55 papers between 1965 and 1970, and 46 papers during the next 5 years. As his former associates and biographers, Hans Kornberg and Derek Williamson, have pointed out, the 100 papers published between his retirement and his death represent a significant contribution to the field of physiological biochemistry. Impressive is the range of subjects studied. Here was no eminent retired scientist ploughing a well-trodden path but an active brain seeking the answers to new questions.

Methodological Challenges

Current policy research focuses almost exclusively on public transfers and primarily on public pension reform. The limited scope of the current policy debate is regrettable for two reasons. First, in some countries family support systems are eroding, and other countries may soon face similar trends. Second, familial transfers and public transfers are related in some respects they are substitutes for each other. Thus, the effect of changes in public transfer policy depends in part on the response of familial transfers. The possibility that public support for the elderly might merely supplant family support has long been appreciated. However, current research efforts are focused almost entirely on family transfers or public policy and not the interaction between the two.

Support available after a stroke and selfmanagement

Two-thirds of people who have had a stroke will need some type of support at home over a period of time. This could be practical support such as help with washing or dressing or psychological support such as motivational techniques, anxiety management. The National Clinical Stroke Guidelines (ISWP, 2008) acknowledge that much of the support will not be provided by health care professionals but will be provided by a mixture of family, carers, charities, local authorities and dedicated organisations. The support available varies considerably from location to location, and even within a 5-mile radius of a large hospital people will be able to access different services. Another complication is that some services are free and some will charge. For practical help such as getting up in the morning, assisting with meal times, and helping with getting dressed, most patients will be assessed by statutory services such as social care and will be recommended for what was known as 'home care'....

Costs of Health Benefits

To answer these questions, Kintner and Swanson (1996) analyzed three possible sources of change in the health benefits group associated with salaried employees at General Motors (GM) (1) flows into and out of GM related to employment processes (2) flows into and out of the health benefits group related to demographic processes and (3) transfers from active employment to retirement or layoff. The GM health benefits group includes employees and their dependents. Employees become eligible for benefits through hiring they lose benefits through quits, discharges, and deaths. Employees also leave this group through layoff or retirement (but may still be eligible for health benefits). Figure 25.1 summarizes the flows into and out of the health benefits group. Additions include new hires and their families, plus births and marriages to employees already belonging to the group. The group loses members through quits, deaths, divorces, and lost eligibility. Transfers occur through retirement and...

Labor Force Characteristics

This company had compiled age data for its overall workforce but had never examined them separately by facility. Doing so revealed that the workforce at some plants exhibited distinctive age structures. Figure 25.2 shows the age structures for two of the company's plants. Plant A has an age structure similar to that of the entire company. Plant B, by contrast, began operations 40 years ago and has a disproportionately older work force. The majority of Plant B's employees are nearing retirement age, foreshadowing the impending loss of many highly experienced employees pre-cisely those employees whose skills would be most difficult to replace. These elementary demographic insights carry several important messages about how the company might prepare for the future. To cushion against the expected future losses of worker skills through retirement, a prudent manager might view existing skills as assets whose value will sharply appreciate in the years ahead. A forward-looking

Spotting Hidden Market Opportunities

Neighborhood vehicles (NVs) encompass a wide range of lightweight contraptions for transporting people within settings that are sheltered from conventional automobile traffic. Unlike golf carts (ubiquitous in retirement communities), NVs travel faster and afford passenger-cargo configurations that can be adapted to fit the varied needs of households at different stages in the life cycle. For example, the same NV platform might suit the needs of four passengers (e.g., grandparents with visiting children or grandchildren) or two passengers (e.g., a childless couple with six bags of groceries). The most likely locations for NVs are master-planned residential communities, either gated or otherwise separated from regular automotive traffic. Such communities represent several distinct markets that might form distinctive niches for NVs for example, retirement communities populated by older adults golf and leisure communities populated by empty-nesters and new towns (e.g., Columbia, Maryland,...

Economics of Spine Care

The year 2008 ended with great economic changes and challenges to be addressed by the incoming Obama administration in 2009. The biggest names in the financial world, such as Lehman Brothers, Merrill Lynch, Bear Stearns, Wells Fargo, AIG, and Citibank were plummeting into ruin. Icons of American industry such as GM, Ford, Chrysler, and others such as Circuit City, were facing complete failure. These financial problems swept the globe in a wave of uncertainty. Many turned to the federal government for bailout support. The government chose an avenue of giving large companies billions of dollars in bailouts and stimulus packages to try to avert a total meltdown of the economy. It is proposed that saving these large businesses as well as creatingjobs through highway improvement and other shovel-ready projects will increase confidence in the financial system and let people feel confident enough to spend money to fuel the economic recovery. This is a somewhat confusing issue, however,...

Research Priorities Of The Handbook Of Population

Thus, policymakers will need to develop possible methods of caring for the older population, and demographers could play a vital role in this process. Future research in this area could provide guidance to countries on methods to increase support for the older population, including increasing international migration for demographic replacement or raising the retirement age. Labor force demography continues to play an important role in demographic research because the size, structure, and changes of the labor force have a significant effect on the population processes, particularly fertility and migration. In her chapter in this Handbook, Sullivan notes that early retirement in developed countries, coupled with declining mortality rates, has resulted in workers in developed countries spending many more years of their lives out of the labor force. In order to provide for the care of these individuals, Sullivan suggests that demographers in the coming years will continue to explore the...

Biomedical Demography

Currently, several major research projects are underway that are headed or co-headed by biomedical demographers. In the United States the three most notable are the Health and Retirement Survey (HRS), the National Long Term Care Survey (NLTCS), and the MacArthur Study of Successful Aging. Soldo played a major role in designing

The Population Policy Process

Various policy actors participate in the different stages of the population policy process. First of all, the regulatory answers to population pressure come directly from individuals, households, and specific social and or geographical groups. These regulatory measures comprise individuals' or households' decisions to seek new economic opportunities (for instance, cultivate new or marginal land), to migrate internally or externally, and to marry later and even choose celibacy (or choose not to have offspring). These varied responses (demographic as well as nondemographic) are said to be multiphasic because they are applied simultaneously or in sequence (Davis 1963). They might also include, for instance, additional savings to increase pension revenues in aging populations. All these answers are social adjustments to population pressure and do not strictly belong to the domain of population policy, even though they might be encouraged by the state.

The Life Span Developmental Model of Creativity

In another study creativity levels were compared between a youngsters' group, a group of middle-aged people, and an elderly group including both recently retired persons and older pensioners. Creativity, as measured in the testing, was present in around two-thirds of the youngsters' group. It was found in half of the middle-aged group of people, and a few percent below that in the retired group. One thing contributing to the relatively modest level of creativity in the middle-aged persons' group could be that these years are pretty stressful, occupied by several duties that draw from the resources available to function creatively. In this comparison of several age groups it is noteworthy that rather many pensioners had signs of creativity when tested, although admittedly most were on the lower end of the scale. It is probable that this group, born during the first two decades in the previous century, had had scant acquaintance with research and psychologists' tests, as well as having...

Vinyl chloride exposure and health effects

A Department for Work and Pensions (2005) review concluded that there was consistent evidence that the inhalation of VCM in PVC production workers causes a characteristic clinical triad of osteolysis of the terminal phalanges, scleroderma, and Raynaud's phenomenon, but not all three are invariably present together (Department for Work and Pensions 2005). These effects occurred in workers who had been exposed to levels of VCM very much higher than the current control limits. Surveys of factory workforces have shown that among those exposed to VCM who do not have radiological evidence of osteolysis, the prevalence of Raynaud's phenomenon and scleroderma is greater than in the general population (by a factor of two).

Four Human Ecological Concepts And The Analysis Of Migration

In other research on nonmetropolitan migration, Frisbie and Poston (1978b) examine the extent to which demographic variables such as racial composition and age structure influence migration, despite the already demonstrated relationships between various components of sustenance organization and nonmetropolitan net migration. They suggest that if, ''as seems to be the case from available evidence, blacks continue to leave nonmetropolitan areas where historically the minority was heavily concentrated, and if whites are not apt to move to these areas in numbers great enough to offset the loss of blacks, it would appear plausible to hypothesize an inverse relationship between percent nonwhite and net migration change'' (Frisbie and Poston 1978b 67). Regarding age structure, they note that numerous nonmetropolitan counties with many elderly residents grow through net migration. However, despite the prevalence of these ''retirement'' counties, they hypothesize that ''one would expect a...

Social security benefits

The UK has had the best social security statistics on back pain in the world over many years (Waddell et al 2002). The Department of Social Security (now the Department for Work and Pensions) has kept diagnostic statistics for disability and incapacity benefits since 1953-1954. Figure 5.9 Current UK trend of incapacity benefit for back incapacities. Based on statistics from the Department for Work and Pensions. Figure 5.10 New awards of incapacity benefit for back pain in the UK. IVB, invalidity benefit, replaced by incapacity benefit (IB) from April 1995. Based on statistics from the Department for Work and Pensions. Figure 5.11 Number of recipients of continuing incapacity benefit for back pain in the UK. IVB, invalidity benefit, replaced by incapacity benefit (IB) from April 1995. Based on statistics from the Department for Work and Pensions. average time off, from the early 1970s to the early 1990s (Table 5.12). Nachemson even forecast that early in the new millennium there would...

Issues Related to Anticipated Losses Other than Impending Death

Most people plan when they will retire however, often little is done in preparation, and little is done to anticipate this event as a major loss of roles and identity in their lives. Often these individuals never seek counselling, but those who do reflect unresolved issues, psychosomatic and psychiatric symptoms, and an inability to reinvest in meaningful living.

Costs of Training Ethical Considerations of Certification

The American Board of Medical Specialties created a task force to investigate competencies (163). They realized that they must adopt a method of reviews that would cover the training of physicians as a continuum from residency through retirement. Depth as well as breadth can be discerned as physicians explore levels of expertise ranging from novice to master, states Leach (164) in a recent article. The Accreditation Council for Graduate Medical Education in 1999 endorsed six general competencies patient care, medical knowledge, practice-based learning and improvement, professionalism, interpersonal and communication skills, and system-based practice. The Professor, Sir William Osler (165), once stated, the whole art of medicine is an observation but to educate the eye to see, the ear to hear, and the finger to feel take time to start a man on the right path, is all we can do.

General Management Goals

A primary consideration is the safety and security of the patient. Patients with dementia or pure amnesia have a limited ability to take care of themselves. Patients should be protected, therefore, from taking actions that may cause injury to themselves and others and for which they can no longer be held responsible. If a patient is still working, a plan for retirement should be initiated. A plan for the daily supervision of the patient should be developed that takes into account the present mental status of the patient and the resources of the family. It is usually advantageous, when possible, for the patient to sustain habits of daily activities in a familiar environment because these habits rely on abilities that are the last to decline. Supervision of the patient must be considered in terms of medical care, diet, medications, and daily activities. A common and difficult problem is determining when certain activities, particularly driving, become potentially dangerous. Legal...

Normal Equilibrium State and Stressors

A patient in crisis enters an emotional storm after a stressor disturbs the normal equilibrium. Environmental precipitants typically seen in a family physician's office include IPV, sickness, and the stress of coping with death, divorce, marital separation, job loss, a financial crisis, and so forth. Disasters are acute environmental crises during which all concerned are focused on basic survival, acute medical care, and provisions of basic human needs. Psychological stressors may be related to events such as witnessing a trauma, surviving a disaster, loss of self-esteem, loss of love, a disturbing dream, sexual dysfunction, or sudden overwhelming fear, panic, or rage. Developmental crises such as latency, puberty, adolescence, marriage, birth of a child, midlife crisis, chronic medical illness, and retirement are common factors precipitating a crisis or may be comorbid factors. Hobson and associates (1998) revised the Holmes and Rahe (1967) social readjustment scale. This newer scale...

Implications Of Mortality Declines For Population Health

An important confound in this debate is the lack of consistent, high quality, and nationally representative data for a lengthy time period (Hayward and Zhang 2001). The National Health Interview Survey for the United States is the longest available time series of morbidity and disability data. However, design and measurement changes make it challenging to use the NHIS data to make strong inferences about historical trends in disability and morbidity. Comparable time series data sets documenting trends are not available outside the United States. United States-based longitudinal panel studies such as the Longitudinal Study of Aging, the National Long-Term Care Survey, the Survey of Income and Program Participation, and the Health and Retirement Survey have also been used to assess recent changes in morbidity and disability. Survey


Angela Lahee, from Springer DE, who was immediately interested in my book proposal, encouraged me to have it published, and provided valuable advice. Ms. Claudia Neumann also helped with many of the details in getting the book printed. I am deeply indebted to Stephen N. Lyle for his expertise and patience in editing my book. I also thank my friend and physician Dr. Philip K. Moskowitz, for keeping me healthy for the last thirty years. I am grateful to Dr. Herbert H. Samuels, Chairman of the Department of Pharmacology of New York University School of Medicine, Langone Medical Center, for providing hospitality and lending support to my efforts, even after my retirement.

Self Confinement

The immediate practical result of the events that took place on 24 November 1926 was that Sri Aurobindo retired entirely to a small, first floor apartment in order to concentrate fully on his inner work. From this time onwards, he left the daily care of the small community that had begun to develop around him, to the Mother, and this was the formal beginning of the 'Sri Aurobindo Ashram.' We know relatively little about what kind of inner work Sri Aurobindo did during the 24 years after his retirement to his rooms. He rarely spoke to anybody and entertained no visitors. Just before the Second World War he broke his leg and needed help for his daily chores. That was the only time when a few of his closest disciples had a chance to know about his daily activities. Otherwise he saw his disciples only 3-4 times a year in a silent 'darshan.' What we know of his inner life during this period is largely from his letters, from his poetry, and from the changes he introduced in some of his...

Suburban Futures

In addition, there is a great need to relate the employment base of suburbs to the types of residents and to their growth patterns. Traditional assembly-line manufacturing is on the decline, and as suggested, the presence of manufacturing workplaces no longer has the same consequences for community character that it once did. It is important to recognize, however, the influence on communities of the dramatic growth of human service industries such as government, health care, retirement services, finance, and real estate. These are undoubtedly having major consequences for the types of persons and families who live in the surrounding areas.

Manual handling

Others show that, when they are off, they return to work more slowly (Fig. 7.3). There is wide variation in long-term disability and early retirement rates in different jobs but, surprisingly, this does not correlate well with the physical demands of work. However, these data do not tell us whether or not heavy work is the cause of more disabling back pain. It could equally be effect. It may simply be more difficult to do a heavy job when you have back pain, whatever its cause.

Empirical Findings

One of the most important changes in the labor force has been the shift in women's age-specific labor force participation rates (Bianchi 1995). In the middle of the 20th century, these rates when graphed against age formed the shape of the letter M. The rates rose through the young adult years, declined after marriage (or later, after first birth), rose after the children had left home, and finally declined again after retirement age. But with each succeeding year, the M shape changed. The graph rose higher each year as the overall labor force participation rates increased. In 1950, women represented less than 30 of the labor force, but by 1980 women were 42 of the labor force (Kutscher 1993). Along with this general rise, the center of the M shape slowly disappeared. Fertility began to decline after 1965. In addition, women were less likely to leave the labor force for any significant length of time following the birth of a child, thus removing the middle of the M. By 1990, the...


In addition to Social Security disability claims, clinicians are often asked to provide opinions on short-term and long-term disability for private insurance, workers' compensation, personal injury claims, military veterans' benefits, state and federal employees' disability retirement programs, accommodations under the Americans With Disabilities Act, fitness for duty eval

The Workplace

In employment litigation also reflects the changing relationship of employees and employers. With job security and guaranteed pensions quickly disappearing, people who feel burned out or mistreated are often less hesitant to bring a suit or claim against an employer. A large company or corporation is easily perceived and portrayed as an impersonal entity that should bear responsibility for injustice or harm incurred in the workplace. People also often hold the belief that unlike individual defendants, businesses can afford to pay large awards or bear disability costs without incurring undue financial hardship.

Massage Therapy

Massage today is considered a respectable and viable complementary technique. Modern massage is used not only as a form of stress reduction and muscle relaxation, but also as an adjunctive treatment for patients in hospitals and retirement centers. It is a central component of Integrative Medicine.

Anticipatory Grief

Anticipatory grief is a term that is most often associated with a terminal illness, with a prognosis of impending death within a stated time period. However, anticipatory grief can refer to a process for any loss that is expected in the future. Many illnesses that are not terminal have characteristics of significant change for the individuals and others involved with them. Heart disease, arthritis, and cancer are only a few of the medical conditions that alter lifestyles and have significant personal losses involved. Geographical moves, job changes, and retirement are also significant losses that are not often recognized as such, but require anticipatory work. The list is extensive, and as mentioned in Chapter 1, losses occur from the time one is born until one dies. Many of these losses could be more satisfactorily resolved if time was spent understanding what has already changed and anticipating what is going to be lost, what the potential effects of this loss are, and what one...

Next Steps

We would like to end this chapter by focusing on two very large reproductive issues on which there is much less agreement about what needs to be done. The first of these is below-replacement-level fertility. In many industrialized countries, current fertility has fallen to levels that in the long run and in the absence of immigration would lead to population decline. In Europe as a whole, the TFR is now 1.4, which implies a population loss of about one third from one generation to the next and an age distribution with an unprecedented percentage of the population past the now customary age of retirement. In some countries, the TFR is well below 1.4, implying even faster rates of decline and an even more elderly age distribution. At this juncture, while the affected countries have certainly taken note of the phenomenon, there is no consensus that below-replacement-level fertility represents an important threat to social welfare, nor any well-developed understanding of the factors that...

Police requirements

In recent years, attacks have been directed at an increasing variety of individuals. No longer are the law enforcement agencies the only targets. Stab-resistant body armour is issued to a number of official agencies. These include the Prison Service, the Home Office Immigration and Nationality Directorate, HM Customs and Excise, the Department for Work and Pensions, the Department of Constitutional Affairs, various trading standards offices, Parks Security, British Transport Police, the London Ambulance Service and various security companies.

Research Findings

Conversely, situations of prolonged declines in fertility, demographic aging, and depopulation can have negative consequences for the economy. The financing of retirement schemes, both pay-as-you-go plans and capitalization systems (as the case of Chile), becomes a problem when the proportion of workers diminishes compared to that of the retired population. Health expenditures also grow more rapidly in aging populations. Another, less well-known aspect is the slowing down of the economy that could be caused by prolonged subreplacement fertility (Chesnais 1995). The relatively higher unemployment levels in Europe and Japan could be explained in part by the decrease in fertility, its related negative impact on investments (housing, equipment, infrastructures, etc.), and the lack of consumers that depresses certain sectors of the economy (e.g., education, leisure). This could also, over the long term, jeopardize the stability of fiscal systems (Faruqee and Muhleisen 2001) and create an...

Other Issues

Indirect costs, defined as lost productivity, include time off work or school, either patient or relative, premature retirement and death. Indirect costs may account for up to 50 of the cost of asthma. So, the economics of asthma inform us that a large population of mild-to-moderate asthmatics has a low daily cost. For some of these patients, the disease becomes uncontrolled and costly, with hospitalisations and time off work or school, possibly progressing into early retirement or death. Some of these cases are probably due to bad compliance with treatment regimens. International guidelines therefore stress that prophylactic treatment should be introduced at an early stage in asthma treatment, resulting in an increase in drug and general practitioner costs, but hopefully leading to reduced hospitalisation costs and indirect costs. As an observation on this topic, it can be mentioned that the cost of the avoidance of one admission to hospital will pay for about 3 years of treatment...

Case Vignette

The effects of stress on an officer's physical and emotional health are well documented. Problems include an increased risk of alcohol drug abuse, is-chemic heart disease, marital problems, excessively aggressive conduct, premature retirement, disability, and possibly an elevated suicide risk (Davey et al. 2000 Hem et al. 2001 Neylan et al. 2002 Richmond et al. 1998 Tuchsen et al. 1996), although recent data have raised some questions about suicide risk (Marzuk et al. 2002).

Social interactions

Aspects of work 250 Incapacity for work 251 Unemployment 252 Early retirement 253 Socioeconomic issues 255 Workers' compensation 255 Litigation 258 Social security 258 Healthcare 260 Conclusion 261 References 261 Culture Family Social class occupation education Job satisfaction and psychosocial aspects of work Unemployment Early retirement Workers' compensation Litigation Social security hin behavior Disability Health care and sick certification Sickness absence Social security claims and benefits Early retirement Torstensen (1996) and Vikne (1996) looked at back pain in top Norwegian athletes, and compared them with chronic low back pain patients in the general population (Table 13.2). About 10 of all athletic injuries involve the spine, and 25-40 of these are serious problems such as fractures or spondylolysis. But chronic disability due to a simple back strain is rare in athletes. Even among elite soccer players who get frequent musculoskeletal injuries, early retirement because of...

Talhin Ka Matlab

Waldmann. 1995. Race and education differences in disability status and labor force attachment in the health and retirement survey. Journal of Human Resources 30 S227-S267. Gendell, M. 2002. Short work lives, long retirements make saving difficult. Population Today 30 5, 10. Guillemard, A., and M. Rein. 1993. Comparative patterns of retirement Recent trends in developed societies. Annual Review of Sociology 19 469-503. Han, S., and P. Moen. 1999. Clocking out Temporal patterning of retirement. American Journal of Sociology 105 191-236. Hatch, L. R. 1992. Gender differences in orientation toward retirement from paid labor. Gender & Society 6 66-85. Hayward, M. D., and W. R. Grady. 1990. Work and retirement among a cohort of older men in the United States, 1966-1983. Demography 27 337-356. Lee, C. 2001. The expected length of male retirement in the United States, 1850-1990. Journal of Population Economics 14 641-650. Wise, D. A. 1997. Retirement...

Patient Encounter

A 78-year-old Caucasian man presents to the emergency department with complaints of a headache persisting over the last 3 days. Repeated BP measurements average 200 110 mm Hg. He reports no other symptoms physical examination and laboratory tests are unremarkable as is his past medical history with exception of hypertension diagnosed in his early 60s. He reports he is struggling on a fixed retirement income with no prescription coverage and takes what I can afford. BP medications are metopro-lol succinate (Toprol XL) 200mg once daily, amlodipine 10mg (Norvasc) once daily, torsemide (Demadex) 10 mg once daily, and valsartan (Diovan) 320 mg once daily.

The problem

Medicine has made great advances over the past two centuries and especially since World War II. We have developed powerful tools to treat disease. Medical technology and resources reached a peak in solving the mystery of life itself in DNA, in our ability to replace hip joints and even transplant hearts. We now have cures that past generations would literally have thought were miracles. We have vaccines to prevent polio and drugs to cure tuberculosis. We have high-tech investigations that lay bare the anatomy and pathology of the spine. We can perform bigger and better operations. Yet we have no answer for ordinary backache. Modern medicine has been very successful in treating many serious spinal diseases, but this whole approach failed with back pain. For all our efforts and skill, for all our resources, low back disability got steadily worse (Fig. 1.1). Rising trends of work loss, early retirement, and state benefits all show our failure to solve the problem. By the end of the 20th...


In the US (Yelin 1997) and the UK (Erens & Ghate 1993), between one-third and one-half of social security claimants have more than one long-term health problem. Of Americans awarded social security disability pensions in 1996 for back pain, 40 also had neck pain and 25 also had a mental health diagnosis.

Family history

She was eldest of four siblings she had three younger brothers. A female cousin spent several years in Knowle Hospital in the 1960s (reason unknown) and her father suffered from alcoholism. He died in 1984 aged 66 from stomach cancer, but the patient claimed I took no notice. He worked as a driver until retirement at 60. The patient did not feel close to her father even though she did not mind him. She later disclosed that he was drinking day and night, but denied that he was violent or had similar problems to her own.

Multimodal Treatment

Coping mechanisms have also been well studied. Catastrophizing, searching for information, and cognitive control can be measured. Self-evaluation of the potential for return to work, application for pension, length of absence from work, and subjective sense regarding the extent of the disability correlate well with return to work, whereas coping strategies per se, or their alterations, failed to predict return to work. Physical variables also poorly predict return to work as outlined in the preceding section. The patient's outlook regarding the future has repeatedly been identified as one, if not the key, indicator for predicting outcome. Patients with an optimistic outlook perceive a greater control over pain and endorse coping strategies that involve diverting attention, ignoring pain, and making coping self-statements. 183


Other than the normal or bell curve - are often encountered. They signal something called heterogeneity - incompatible or nonproportionate elements. For example, future health is in part a function of prior health, so that some authorities suggest that a cohort divides itself into two modes, one with a high and the other with a low propensity to be sick. Thus, an average figure - such as the average age for retirement, 65 - may misstate cohort experience in such circumstances.

Comparative Studies

Prospective randomized studies in which one stitch per side was utilized have shown mixed results. Su et al. (71), utilizing two to three stitches per side for open colposuspensions but only one stitch per side on most of their laparoscopic colposus-pensions, showed objective cure rates of 80.4 and 95.6 for laparoscopic and open colposuspensions, respectively. These patients had a minimum one-year follow-up and objective cure was defined as dry on urodynamic testing. Interestingly, on a one-hour extended pad test, the laparoscopic group showed a slightly greater improvement than the open group, although there was no statistically significant difference between the groups pre- or postoperatively with respect to this measure. As previously discussed, the difference between one stitch and two per side likely accounts for the difference in outcomes. In 2001, Fatthy et al. (72) published a study in which one suture per side was utilized for both the open and laparoscopic colposuspensions.

Developmental losses

Often developmental losses compound or confuse more visible losses. A 65-year-old whose job position is eliminated is also coping with developmental issues of aging and possible retirement. An adolescent being 'dumped' by a lover may also be experiencing losses inherent in that stage of development. A major loss during the adolescent period of development is to let go of carefree ways and to become responsible. And for children who lose significant others through death, the grief process may span their developmental stages. For children, at each new stage of development, the loss will be re-evaluated and new meaning will be integrated. Developmental losses can take many forms


For Criterion A there must be evidence for at least one clear and identifiable incentive for exaggeration or fabrication, for example a personal injury settlement, disability pension, evasion of criminal prosecution or release from military service. For Criterion B there must be evidence of exaggeration or fabrication on neuropsycho-logical testing as demonstrated by (1) definite negative response (2) probable negative responses bias (3) a discrepancy between the test data and known patterns of brain functioning (4) observed behaviour (5) reliable collateral reports or (6) documented background history. Criterion C focuses on evidence from self-report that is noted to be discrepant from (1) documented history, (2) known patterns of brain functioning, (3) behavioural observations, (4) information obtained from collateral informants or (5) evidence of exaggerated or fabricated psychological dysfunction. Criterion D indicates that the observed behaviours are not otherwise explained by...